Escitalopram (A complete overview)


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Page last updated: 18/10/2022


In this brief blog, we will discuss what escitalopram is, what the effects are and what you should consider before taking escitalopram.

What is Escitalopram?

Escitalopram is an antidepressant used to treat depression and anxiety. It is in a class of drugs known as selective serotonin reuptake inhibitors (SSRI).

Escitalopram will help improve your overall mental wellbeing by reducing your anxiety, increasing your excitement and energy whilst reducing any feeling of nervousness you may have.

Escitalopram does this by increasing the amount of serotonin in the brain to a good level.

Escitalopram can be used for:

  • Treatment of generalised anxiety disorder.
  • Treatment of obsessive-compulsive disorder.
  • Treatment of major depressive episodes.
  • Treatment of panic disorder with or without agoraphobia.
  • Treatment of social anxiety disorder (social phobia).

Escitalopram is also called by the brand name Cipralex or Lexapro.

Other drugs used to treat depression and anxiety include drugs such as citalopram.

Escitalopram will usually be prescribed by your doctor so you should never take this drug without a prescription even if you feel that you meet the symptom requirements.]

You should always store escitalopram out of reach of children You should also always follow the dosage guidelines given by your doctor. 

Before taking escitalopram you should also always read the patient information leaflet which you will find inside your escitalopram package as this will contain warnings, information of possible allergic reactions due to taking escitalopram, side effects of escitalopram and the ingredients contained within escitalopram.

If you have any questions or concerns about escitalopram then you should ask your doctor or pharmacist.

You should also read the patient information letter when you seek a refill for escitalopram.

Escitalopram comes in both tablet and liquid form.

If you are consuming the liquid form of the medicine then be sure to measure the dosage before consuming to reduce the risk of an escitalopram overdose.

You can put the drops in water or a clear juice and count the drops to ensure you have the right amount, stir the drink then consume if satisfied that you have put the right dosage.

Escitalopram can be taken by mouth with or without food.  Escitalopram is usually taken once in the morning or once in the evening.

Escitalopram can take up to 4 weeks for you to start feeling its full effects but you can expect to start seeing it work after two weeks.

If more than two weeks have passed and you feel yourself getting worse or not getting much better at all then you should inform your doctor immediately.

To help you remember to take your escitalopram every day you should take it at the same time every day.

If you miss a dosage make sure you take it as soon as you remember as long as it is not on the day after you would have taken the initial dosage.

You should never take two doses to make up for a missed dosage of escitalopram as this could lead to an escitalopram overdose.

If you find that you have taken more than the required dosage requirements of escitalopram then you should go to the nearest A & E immediately.

Do not drive yourself and make sure you take the packet of Escitalopram. 

The dosage of escitalopram your doctor will give you will be based around your personal circumstances. It is important that you don’t increase your dosage without first seeking permission from your doctor.

Th escitalopram prescribed to you will be based on the severity of your condition. This could be your anxiety or depression.

The dosage you are prescribed is also given based on your previous response to treatment from escitalopram or other antidepressants, your age and other medication you may be taken.

When you are going through your assessment prior to your doctor prescribing you escitalopram you should ensure you have informed your doctor about all the current and previous medication you have been on.

This should be everything, even drugs that are bought over the counter without any prescription including supplements, herbal drugs etc.

When being prescribed most antidepressants your doctor will usually start you off on a low dosage and slowly increase your dosage based on your reaction from consuming the drug.

This is the same case with escitalopram. You should not take more than the dosage the doctor gave you if not you could increase the side effects of escitalopram or even have an escitalopram overdose.

You should also not suddenly stop taking escitalopram as this may also leave you with severe withdrawal symptoms.

If you want to stop taking Escitalopram then you should inform your doctor who will slowly reduce your escitalopram dosage.

You should also avoid using escitalopram for more than the required time frame.

You should continue taking your escitalopram dosage even when you feel you are getting better.

If you stop taking your escitalopram dosage you may find that you worsen your condition and even develop withdrawal symptoms.

Escitalopram (A complete overview)

If you suddenly stop taking escitalopram then you may experience symptoms such as:

  • Tiredness
  • Changes in sleep patterns
  • Temporary feelings of what feels like an electrical shock
  • Mood swings
  • Headaches

If you start to experience these symptoms then you should contact your doctor immediately.

Storage of Escitalopram

“You should store at room temperature,  away from light and moisture. 

Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.”

How much escitalopram should you  take

The amount of escitalopram you should take will be based on what your doctor feels is suitable for you. You should not take more than the required amounts your doctor has prescribed for you.

Escitalopram tablets come in different strengths ranging from 5mg to 20mg.

The usual dose of escitalopram is 10mg a day in adults.

But your doctor may start you on a lower dose to monitor how you react to the drug and then increase your dosage to a maximum dose of 20mg a day.

If you have liver problems, the maximum recommended dose is 10mg a day.

With liquid drops of escitalopram, 1 drop is equivalent to 1mg, 10 drops is 10mg, 20 drops is 20mg.

Below we will highlight how much escitalopram you should take based on your condition.

This is just a guide and your doctor will let you know what your required dosage should be.

If you are suffering from depressive illness, generalised anxiety disorder and obsessive-compulsive disorder.

When taking the drug by mouth

An adult should take10 mg once daily; increased if necessary up to 20 mg daily.

An elderly person should initially take 5 mg once daily; maximum 10 mg per day.

If you are suffering from a panic disorder

When taking the drug by mouth

An adult should initially take 5 mg once daily for 7 days, then increased to 10 mg daily; maximum 20 mg per day.

An elderly person should initially take 2.5 mg once daily; maximum 10 mg per day.

If you are suffering from a social anxiety disorder

When taking the drug by mouth

An adult should initially take 10 mg once daily for 2–4 weeks, dose to be adjusted after 2-4 weeks of treatment; usual dose 5–20 mg daily

Should you take Escitalopram?

Escitalopram can significantly change the dynamics of your body so you should consider if you should take escitalopram or not.

  • If you usually have trouble sleeping then it may be best to take escitalopram in the morning.
  • Try to avoid missing any appointments with your doctor as these are key for them to evaluate how you are reacting to the drug.
  • When taking escitalopram you may think about hurting yourself or committing suicide. This is common in people under 25. If you experience these thoughts do not self- harm yourself but rather inform your doctor immediately. These thoughts will usually happen at the beginning stages of the medication but will get better as you get used to the medication.If these thoughts persist then you should go to the A&E immediately with your medicine.
  • If you are under 25 you may notice a lot of hostility, anger and confrontational behaviour being displayed from you. Tell your doctor about this.
  • If you have epilepsy, kidney disease or liver disease then you should tell your doctor before taking escitalopram
  • Do not take escitalopram with the herbal product St. John’s Wort
  • Methadone can make drowsiness worse with escitalopram. The escitalopram could increase the concentration of methadone in your body.
  • If you consume cocaine regularly then you should know that escitalopram could raise the level of cocaine in your body, giving you a bigger reaction.
  • Taking escitalopram with cocaine or ecstasy or amphetamines could bring on serotonin syndrome. You could get a high temperature/fever, agitation, confusion, trembling or weird muscle movements. You need to go to the hospital if this happens.
  • Make sure you properly check the labels of any other drugs you have been given permission to take with escitalopram to ensure they don’t increase the risk of you bleeding or increase drowsiness. If they do then recheck with your doctor on if those drugs are suitable to be taken alongside escitalopram.
  • You must inform your doctor of any other drugs which may cause drowsiness, drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and narcotic pain relievers (such as codeine).
  • Escitalopram may affect the results for medical tests and scans such as Parkinson’s disease and make them false results. Ensure the laboratory staff are aware that you are taking escitalopram before carrying out any tests on you.
  • Escitalopram is a very similar drug to citalopram. You should not take these two drugs at the same time or take any drug that has elements of citalopram.
  • Taking other drugs alongside your escitalopram treatment could affect the effectiveness of those drugs or escitalopram and in some cases can cause a fatal combination. Do not start taking any medications without first getting approval from your doctor.
  • Escitalopram can make you very drowsy and dizzy. You should avoid taking it with narcotic or alcohol as this can make you severely drowsy, impair your motor skills and cause you to fall and hurt yourself. You should not drive, handle any heavy machinery or perform any task which has a high risk of self harm or requires you to be fully alert if you have taken escitalopram and are not fully used to it as it is your first few weeks of using it or if you have taken escitalopram and consume alcohol. If you intend on taking escitalopram with alcohol or drugs then please inform your doctors immediately.
  • You should not stop taking your escitalopram treatment without your doctor instructing you to. If you do this you may worsen your depression, anxiety, obsessive-compulsive disorder or panic disorder condition.
  • You should avoid taking any MAO inhibitors with this drug as the combination of escitalopram and MAO inhibitors could cause a fatal interaction. You must avoid taking these MAO inhibitors: isocarboxazid, linezolid, procarbazine, rasagiline, safinamide, methylene blue, moclobemide, phenelzine, selegiline and tranylcypromine during your escitalopram treatment. You should not take any MAO inhibitor without first seeking permission from your doctor. In most cases, you shouldn’t take any MAO inhibitors 2 weeks before and 2 weeks after your treatment.
  • You should inform your doctor of any allergic reactions you may have to other drugs but especially to citalopram and escitalopram. Escitalopram may contain inactive ingredients which may cause allergic reactions or more severe problems.
  • Escitalopram can affect your heart rhythm (QT prolongation). This can be fatal as you begin to have a very fast and irregular heartbeat along with severe fainting or dizziness. You should seek medical help as soon as possible. QT prolongation can be caused by other drugs which you may be taking or if you have other health conditions which may increase the likelihood of you developing QT prolongation when escitalopram is consumed. You should always inform your doctor of all the medications you have taken in the past or are currently taken. You should also inform your doctor of any medical conditions you have, especially any of these conditions: recent heart attack, slow heartbeat, recent heart failure, family history of heart problems, QT prolongation in the EKG, family history of certain heart problems and recent cardiac arrest.
  • You should avoid any other drugs which may affect the heart rhythm and thereby increase the risk of QT prolongation. These drugs include but are not limited to amiodarone, pimozide, procainamide, quinidine and sotalol. 
  • Before taking escitalopram you should always inform your doctor of previous prescriptions and non-prescription drugs which you have taken or are currently taking. You should also inform your doctor if there is a family history of heart disease, suicide, liver disease, seizures, bipolar disorders, intestinal ulcers, bleeding problems, peptic ulcer disease, manic depressive disorder, low sodium level in the blood and glaucoma.
  • Before having surgery ensure you tell your doctor, surgeon or dentist of all prescription, non-prescription, a supplementary and herbal medication which you are currently taking or have taken in the past.
  • The side effects of escitalopram may affect children more severely than they affect adults. You may find that a child will lose their appetite and lose weight when taking escitalopram. You should take regular measurements for both weight and child when a child is taking escitalopram. You should also monitor their food intake and ensure they are getting as much food as they need if not they will feel the effects of the drug on an empty stomach. Effects such as dizziness, tiredness and sleepiness.
  • If breastfeeding you should be aware that escitalopram passes into your breastmilk and this means your baby will consume small doses of this which may have some minor risks to your baby. You should speak to your doctor about this if you are breastfeeding and prescribed escitalopram.
  • If you are planning to be pregnant or have recently become pregnant then do not stop using this medicine suddenly. Inform your doctor and he will explain your options alongside the advantages and disadvantages of each.
  • If you are pregnant then you should be aware that escitalopram may have some risks to your unborn baby. You should discuss this with your doctor immediately. Your doctor will advise you in if you should stay on the medication and if not how you will come off it. Escitalopram should be avoided during pregnancy and used only when the need is great. If you had just had a baby and you were on escitalopram within just the last 3 months of your pregnancy then you may find that babies born in this condition will rarely develop withdrawal symptoms. The withdrawal symptoms normally seen in babies whose mothers have been on escitalopram include constant crying, muscle stiffness, seizures, feeding and breathing difficulties. You should contact your doctor immediately if you notice any of these symptoms.
  • If you have been diagnosed with low levels of magnesium or potassium in the blood then this may increase your risk of QT prolongation. The risk of QT prolongation may increase further if you take escitalopram during the same period when you take other drugs such as diuretics. You may notice severe conditions of throwing up, diarrhoea and sweating. These are not normal conditions and you should inform your doctor immediately.
  • Elderly people may be more vulnerable to the side effects of escitalopram such as dizziness, loss of coordination(which means they could fall easily and hurt themselves), bleeding and QT prolongation. Elderly people may also be more likely to lose too much salt (hyponatremia), especially if they are also taking “water pills” (diuretics) with this medication.
  • If you have diabetes or any condition that requires you to limit your sugar intake such as phenylketonuria then you should be aware that the liquid form of escitalopram may contain aspartame and sugar. You should discuss this with your doctor.
  • Aspirin may increase the risk of bleeding when taken with escitalopram. You should only take these two together when your doctor has directed you to and you should not stop until your doctor directs you to. 
  • You may be able to take Ibuprofen and blood thinners such as warfarin with escitalopram but you should seek your doctor’s advice and permission first.
  • You should avoid taking any drugs which increase serotonin as these drugs may increase your risk of serotonin syndrome or toxicity. This is more likely to happen when you start or increase the dosage of those drugs which increase serotonin. Drugs such as MDMA/”ecstasy,” St. John’s wort, certain antidepressants (including other SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), and tryptophan.

What are the side effects of escitalopram?

Escitalopram will usually have the following side effects in their mild form.

If you find that any of the below are increasing and becoming more severe then you should inform your doctor immediately.

The product information leaflet inside the escitalopram package will contain more detailed information on the side effects of escitalopram.

Some of the side effects of escitalopram include:

In some rare occasions, men will experience a painful or prolonged erection lasting for more than 4 hours. You should seek immediate medical help to prevent irreversible damage.

Serious side effects of Escitalopram

Most people who use escitalopram will not experience any serious side effects but if you find yourself experiencing any of the below then you should inform your doctor.

  • decreased interest in sex
  • changes in sexual performance 
  • bruising
  • Bleeding.
  • You feel overly excited
  • Blocked or running nose
  • Weight gain
  • Fever
  • Yawning
  • Strange dreams
  • Difficulty going to sleep
  • Pains in joints and muscles
  • Change in appetite
  • Tingling in hands or feet

If you encounter any of the following severe side effects then you should seek emergency help immediately by going to the nearest A&E with the packet of the drug

  • Fainting
  • Uneven heartbeat- his could mean a life-threatening condition called ‘torsades de pointes’
  • Seizures.
  • Swelling eyes
  • Swelling face
  • Constant headaches
  • Unusual throw up
  • Bloody stool
  • Black stool
  • Redness of eye
  • Eye pains
  • Widened pupils
  • You start trembling
  • Unusual muscle movements
  • Blurred vision
  • Unexplained vision changes such as seeing rainbows at night
  • Difficulty going for a tinkle (urinating)
  • Yellowing of the skin and the whites of the eyes
  • Bleeding gums or bigger gums for no explainable reason
  • muscle cramps – these can all be signs of low sodium levels in your blood (in severe cases, low sodium can lead to seizures)
  • A body temperature of over 38C

You may be experiencing an allergic reaction to escitalopram if you experience any of the below:

  • you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
  • your mouth, face, lips, tongue or throat start swelling
  • you’re wheezing
  • you get tightness in the chest or throat
  • you have trouble breathing or talking

Serotonin toxicity

You should also seek immediate medical help at the A&E if you feel you have serotonin toxicity. This is a condition caused by too much serotonin being produced in the brain.

You may be at risk of this condition if you take other drugs which increase the production of serotonin whilst taking escitalopram.

Before getting any other medication whilst on escitalopram you should always inform your doctor or pharmacists that you take escitalopram.

Symptoms of serotonin toxicity whilst on escitalopram include:

  • fast heartbeat
  • Hallucinations
  • loss of coordination
  • severe dizziness
  • severe nausea
  • throw up
  • Diarrhoea
  • twitching muscles
  • unexplained fever
  • unusual agitation
  • restlessness.

Allergic reactions to escitalopram

Allergic reactions to escitalopram are rare but if you notice any of the below symptoms then seek immediate medical help.

  • Rash
  • Itching
  • Swelling of the tongue
  • Swelling of the face
  • Swelling of the throat
  • severe dizziness
  • trouble breathing

Risk of overdose when consuming Escitalopram

You should never take two doses as a way to make up for a missed dose of escitalopram as this may lead you to overdosing.

You should never share your medication with others regardless of how familiar their symptoms look.

You may be experiencing an overdose if you experience any of the below symptoms.

  • shaking
  • a fast heart rate
  • seizures
  • feeling agitated
  • being sick (throwing up)

If you experience any of these symptoms then you should go to the A&E immediately with the packet of your escitalopram. Do not drive there.

Escitalopram FAQs

We will briefly cover some frequently asked questions on Escitalopram which is also known as Lexapro.

Are Lexapro and Xanax the same thing?

No Lexapro and Xanax are not the same things. Lexapro is primarily used to treat depression whilst Xanax is used to treat panic attacks.

Lexapro is a selective serotonin reuptake inhibitor (SSRI) and Xanax is a benzodiazepine. 

How long does it take for Lexapro to work for anxiety?

Lexapro may begin working within the first 2 weeks and you could see some improvement in your anxiety during this period.

It is also very possible that you could become more anxious during this initial stage or see no changes at all.

Inform your doctor about this but continue using the drug as you will likely see it working more during the 4th week.

Is Lexapro good for anxiety and panic attacks?

Yes, Lexapro is now used as an off-table drug for anxiety and panic attacks.

When should I take Lexapro morning or night?

If you are having difficulty sleeping then you should take Lexapro in the morning.

If you find that the Lexapro is affecting your working day then you should take Lexapro at night.

Is Lexapro dangerous?

Lexapro isn’t dangerous but could lead to severe problems including death if not correctly managed.

Can Lexapro help you sleep?

Yes, Lexapro can help you sleep.

You may find that within the first 2 weeks of taking Lexapro it gives you insomnia instead of helping you sleep.

Don’t worry about this. Inform your doctor and keep taking the drug.

Your doctor may prescribe you a separate drug to help you sleep.

Can Lexapro cause hair loss?

In some rare cases, Lexapro can cause hair loss.

This is because Selective serotonin reuptake inhibitors (SSRIs) can cause hair loss.

The hair loss caused by Lexapro is reversible and will usually stop once the usage of the drug has stopped.

Is Lexapro immediate?

No, Lexapro does not usually work immediately.

You will usually start to see Lexapro work within the first 2 weeks and at the 4th week on you should see the full effects of Lexapro.

Can Lexapro increase anxiety?

Lexapro can help reduce the symptoms of anxiety but you may find in the first few weeks of consumption that you feel more anxious.

Does Lexapro help with anger?

Lexapro may be able to help you with anger but this isn’t the main role of Lexapro.

There are more antidepressants such as Prozac, Celexa and Zoloft which are prescribed to people who have anger issues.

These drugs will help you feel a lot calmer and avoid getting angry.

Is Lexapro physically addictive?

Lexapro is not an addictive drug but if you abuse it then you can become addicted to Lexapro.

If you have become addicted to Lexapro you should seek medical advice from your doctor.

Can I take ibuprofen with Lexapro?

You may be able to take Ibuprofen with Lexapro but you should seek medical advice from your doctor before doing so as Ibuprofen could increase your risk of bleeding.

Bleeding maybe even more likely to occur if you have kidney or liver disease or are elderly.

Does Lexapro help with social anxiety?

Yes, Lexapro or escitalopram has been used to treat social anxiety disorder and can, therefore, help with social anxiety by making you much calmer and easy to relate with.

Does Lexapro help you focus?

Lexapro will help you increase your level of focus as you have more energy and you feel better.

This will help you focus and concentrate on whatever you are doing.

You will find that after taking Lexapro you become less restless, irritable and focus better.

Does Lexapro cause memory loss?

No, Lexapro doesn’t cause memory loss. On the contrary, research carried out at Loyola University Medical Center found treating depression patients with escitalopram, or Lexapro caused them to prevent memory loss as it caused the levels of two neurotoxic compounds which cause dementia to fall.

Can I lose weight with Lexapro?

Lexapro’ can cause people to lose weight but why it does so is not yet now, It is assumed that Lexapro causes people to lose weight as it reduces their appetite for food.

If you severely lose or gain weight whilst taking Lexapro then you should contact your doctor and inform them immediately.

Disclaimer: Our goal is to provide you with the most relevant and current information.

However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice.

Always discuss possible side effects with a healthcare provider who knows your medical history.

If you are under 18 then CAMHS, an NHS run programme may just be the answer for your mental health struggles.

You should look to see if you meet the CAMHS referral criteria and then fill in the CAMHS referral form.